scholarly journals The Palliative Care Service and the Stem Cell Transplant Unit – a Happy Marriage

2016 ◽  
Vol 22 (3) ◽  
pp. S363 ◽  
Author(s):  
Catherine Wood ◽  
Alison Rowe ◽  
Alwyn D'Souza ◽  
Lisa Speedy ◽  
Jonathan Adler ◽  
...  
Keyword(s):  
Palliative Care ◽  
Stem Cell ◽  
Stem Cell Transplant ◽  
Care Service ◽  
Palliative Care Service ◽  
Cell Transplant ◽  
Happy Marriage

scholarly journals Perceptions of specialty palliative care and its role in pediatric stem cell transplant: A multidisciplinary qualitative study

2021 ◽  
Author(s):  
Griffin S. Collins ◽  
Hannah Beaman ◽  
Alvin M. Ho ◽  
Michelle L. Hermiston ◽  
Harvey J. Cohen ◽  
...  
Keyword(s):  
Palliative Care ◽  
Stem Cell ◽  
Qualitative Study ◽  
Stem Cell Transplant ◽  
Cell Transplant

Characterizing advance care planning, palliative care utilization, and location of end-of-life for adult allogeneic hematopoietic stem cell transplant recipients.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 7034-7034
Author(s):  
Stephanie Hoffman ◽  
Pavan Reddy ◽  
John Martin Magenau ◽  
Attaphol Pawarode ◽  
Brian Parkin ◽  
...  
Keyword(s):  
Palliative Care ◽  
Stem Cell ◽  
End Of Life ◽  
Hematopoietic Stem Cell Transplant ◽  
Stem Cell Transplant ◽  
Patient Characteristics ◽  
Cell Transplant ◽  
Care Planning ◽  
Hematopoietic Stem ◽  
Advance Care

7034 Background: The impacts of advance care planning (ACP) on end-of-life (EOL) outcomes in allogeneic hematopoietic stem cell transplant (allo HCT) recipients are not well known. ACP includes advance directive (AD) completion, and palliative care (PC) consultation. Using these two components, we aimed to explore the current state of ACP and its impact on EOL outcomes in allo HCT recipients to provide the groundwork for future prospective studies. Methods: We performed a retrospective study of deceased adult patients who underwent allo HCT between December 2015-December 2019. We summarized patient characteristics, the rate of AD completion, PC consultation, and location of end-of-life (EOL). Univariate and multivariate analyses were performed to evaluate patient characteristics that may be associated with AD completion, PC consultation and assess the impact of these two factors on location of EOL. Results: See Table for summary of patient characteristics. Of the 125 patients included, we found that 66% (n = 82) completed ADs. All patients with ADs completed them prior to undergoing transplant and never modified them. The majority of patients (84%) with an AD expressed the desire to avoid life-sustaining treatment in the event of terminal illness or irreversible coma. PC was consulted for 46% (n = 58) of patients within 6 months prior to time of death (TOD). Regarding location of EOL, 30% of all patients died in the hospital (non-ICU), 20% in the ICU, 38% at home with hospice, and 10% in a hospice facility. Patients with ADs appeared more likely to die outside of the hospital compared to those without (53% vs. 44%, p = 0.4506). By multivariate analysis, there were no significant patient characteristics associated with the presence of an AD or PC consultation. After adjusting for age and comorbidity index, we found that patients with an AD were significantly more likely to die outside of the ICU (OR 3.0, 95% CI 1.2-7.5, p = 0.02), an effect that was further amplified in patients who both had an AD and received PC consultation at any point (n = 30, p = 0.0077). Conclusions: Our findings highlight the importance of ACP for EOL outcomes in the allo HCT population. While the rate of AD completion in our study population is higher than that of prior studies, future prospective studies aimed to improve the rate of ACP are needed.[Table: see text]

Are families the barrier? Evaluating attitudes toward early integration of palliative care in pediatric hematopoietic stem cell transplant.

2016 ◽  
Vol 34 (26_suppl) ◽  
pp. 112-112
Author(s):  
Deena R. Levine ◽  
Justin N. Baker
Keyword(s):  
Quality Of Life ◽  
Palliative Care ◽  
Stem Cell ◽  
Hematopoietic Stem Cell ◽  
Hematopoietic Stem Cell Transplant ◽  
Stem Cell Transplant ◽  
Cell Transplant ◽  
Hematopoietic Stem ◽  
Early Integration

112 Background: The benefits of early integration of palliative care (PC) in oncology have been well established yet, there remain significant barriers to PC integration, especially in the setting of pediatric hematopoietic stem cell transplant (HSCT). HSCT patients are prone to a great degree of treatment related toxicity and are at high risk for morbidity and mortality and, while ideally suited to benefit, inherent factors in this cure oriented field preclude the integration of PC services. Most notably, family receptivity to PC is often perceived as a barrier in HSCT yet there is no data on family attitudes toward PC in this setting. This study aimed to evaluate perceived symptom burden and patient and parent attitudes toward early PC integration in pediatric HSCT. Methods: After IRB approval, development and pre-testing, novel survey tools were administered to HSCT patients and parents. Eligibility criteria included parent of an HSCT recipient < age 10 or patient/parent dyad for patients aged 10-17, time from HSCT > 1 month and < 1 year, English-speaking, and consent/assent. Data was assessed for trends in response content frequencies, percentages and parent/child concordance. Results: Interim analysis of the first 34 participants revealed high levels of perceived symptom related suffering in the first month of HSCT with suffering from: nausea 96%, loss of appetite 88%, diarrhea 88%, pain 83%, depression 79%, anxiety 75%, and constipation 42%. 90% of patients and 71% parents expressed that a great deal or a lot of attention should be paid to quality of life from the start of HSCT. The majority of patient and parent respondents (60/46%) indicated they would likely want to meet with PC early in HSCT and very few reported definite opposition (0% children, 4% parents). Conclusions: Pediatric HSCT patients experience a high degree of symptom related suffering, perceive quality of life as a high priority, and are largely in favor of early PC involvement. Our findings suggest that family receptivity should not be a barrier to early PC in pediatric HSCT and that aggressive cure directed therapy can and should be accompanied by aggressive quality of life directed care through early PC integration.

scholarly journals Perceptions of Specialty Palliative Care and Its Role in Pediatric Stem Cell Transplant: A Multi-Disciplinary Qualitative Study

2021 ◽  
Author(s):  
Griffin Collins ◽  
Hannah Beaman ◽  
Alvin Ho ◽  
Michelle Hermiston ◽  
Harvey Cohen ◽  
...  
Keyword(s):  
Palliative Care ◽  
Stem Cell ◽  
Stem Cell Transplant ◽  
Palliative Care Team ◽  
Care Team ◽  
Cell Transplant ◽  
Team Members ◽  
Care Integration ◽  
Palliative Care Consultation ◽  
Care Consultation

Background Consultation of specialty palliative care remains uncommon in pediatric stem cell transplant (SCT) despite growing evidence that early integration of palliative care improves outcomes in patients with advanced cancers or undergoing SCT. Little is known about how multidisciplinary pediatric SCT teams perceive palliative care and its role in SCT. Procedure We conducted semi-structured interviews of members of a multi-disciplinary SCT team to understand their perceptions of palliative care, how specialty palliative care is integrated into SCT, and to identify barriers to increased integration. Eligible participants included physicians, nurses, nurse practitioners, social workers, and child life specialists. Data was analyzed using thematic analysis. Results Four major themes were identified. First, SCT team members held a favorable perception of the palliative care team. Second, participants desired increased palliative care integration in SCT. Third, participants believed that the palliative care team had insufficient resources to care for the large number of SCT patients which led to the SCT team limiting palliative care consultation. And, finally, the lack of a standardized palliative care consultation process prevented greater integration of palliative care in SCT. Conclusions SCT team members held a favorable perception of palliative care and saw a role for greater palliative care integration throughout the SCT course. We identified modifiable barriers to greater palliative care integration. SCT teams who desire greater palliative care integration may adapt and implement an existing model of palliative care integration in order to improve standardization and increase integration of specialty palliative care in SCT.

scholarly journals Optimizing the delivery of early palliative care for hematology patients receiving a stem cell transplant: A role for a Nurse Practitioner

2020 ◽  
Vol 30 (4) ◽  
pp. 239-245
Author(s):  
Ellen Lewis
Keyword(s):  
Palliative Care ◽  
Stem Cell ◽  
Nurse Practitioners ◽  
Nurse Practitioner ◽  
Stem Cell Transplant ◽  
Cell Transplant ◽  
Hematopoietic Stem ◽  
Early Palliative Care ◽  
Care Services ◽  
Palliative Care Services

A hematopoietic stem cell transplant (HSCT) is an intense treatment approach for patients with a hematologic malignancy and brings a significant risk for morbidity and mortality. HSCT brings hope of cure for patients; however, treatments are lengthy and burdensome from both a physical and psychosocial perspective. As the culture of HSCT has traditionally been cure-oriented, it leaves little room for a potential partnership with palliative care services, and when palliative care services are introduced, it is often too late for significant benefit. The need to standardize palliative care involvement for patients with hematologic malignancies receiving a HSCT has become necessary, yet there are challenges with the best way to create such a partnership. Nurse practitioners are a steadily growing professional body possessing the knowledge and skill necessary to fill the gap in palliative care delivery for HSCT patients. The proposed Nurse Practitioner Early Palliative Care for HSCT patients (NEST) algorithm will seek to provide a pathway in which to foster a partnership between hematology/HSCT teams and palliative services to yield the best care possible for patients.

Development of a Division-Based, Longitudinal Palliative Care Registry for Pediatric Oncology and Stem Cell Transplant Patients

PEDIATRICS ◽  
2016 ◽  
Vol 137 (Supplement 3) ◽  
pp. 311A-311A
Author(s):  
Bryan A. Sisk ◽  
Emily Attig ◽  
Donna B. Jeffe ◽  
Frederick S. Huang ◽  
Robert J. Hayashi ◽  
...  
Keyword(s):  
Palliative Care ◽  
Stem Cell ◽  
Pediatric Oncology ◽  
Stem Cell Transplant ◽  
Cell Transplant ◽  
Transplant Patients
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